Incarceration and adult weight gain in the National Survey of American Life (NSAL)

Abstract

The United States has the unenviable distinction of having both the highest obesity rate among Organisation for Economic Co-operation and Development (OECD) member countries and the highest incarceration rate in the world. Further, both are socially patterned by race/ethnicity and socioeconomic position. Incarceration involves various health behaviors that could influence adult weight trajectory. We evaluated the associations between history and duration of adult incarceration and weight gain using the National Survey of American Life (N=6,082 adults residing in the 48 contiguous states between February 2001 and March 2003). We propensity score-matched individuals to control for the probability of having a history of incarceration. To examine the relation between prior incarceration and adult weight gain, we fit gender-stratified generalized estimating equations controlling for propensity of incarceration history, age, education, income, race/ethnicity, and marital status. For males (N=563), incarceration was associated with about a 1.77 kg/m2 lower gain in body mass index (BMI) during adulthood, after adjusting for age, education, income, race/ethnicity, and marital status in addition to the propensity of having a history of incarceration (95% CI: −2.63, −0.92). For females (N=286), no significant overall relationship was found between a history of incarceration and adult weight gain. In subgroup analyses among those with an incarceration history, we found no overall association between duration of incarceration and adult weight gain in men or women. In sensitivity analyses, neither tobacco smoking nor parity changed the results. The results of this study indicate that incarceration is associated with a lower transition of weight gain in males, but not females.

How Incarceration Influences Native-Born Black Men’s Risk of Obesity

“…As such, experiencing a family disruption firsthand because a relative is in jail or prison creates compounding difficulties from which Black people, families, and communities may never recover. Findings reported here and elsewhere 12,[22][23][24][25]27,30,32 confirm that the incarceration of Black men should be considered a public health crisis.…”

“…Consistent with Model 1, former incarceration negatively associated with obesity, replicating findings reported by Bailey et al who used the same data as this study. 27 This salutogenic effect may be a function of cigarette smoking, 23 which may start in jail or prison and tends to suppress weight gain, but evidence that the culprit is cigarette smoking is equivocal. 27 …”

Body image distortion and dissatisfaction in incarcerated women

“…In this study, the SSF figures identified by women as representing them before imprisonment were, in most cases, smaller bodies than those identified to represent their current body, revealing their perception of weight gain during incarceration. Weight gain was also high in other studies with inmates [11,12,15,16], being more prevalent in women [16,17]. This phenomenon may be related to inadequate diet with low consumption of healthy foods and high consumption of industrialized food, sedentary life style, without working programs or recreational and physical activities, depression or even drug abstinence, and the use of atypical antipsychotic medications [6,[9][10][11]15,16,18].…”

Understanding Weight Change while Incarcerated: Qualitative Groundwork for a Collaborative Health Intervention

“…Some of this work has documented incarceration as an independent risk factor for unhealthy weight status as well as chronic disease burden. Other recent work, for example Bailey et al [14] study, demonstrate a more complex relationship between incarceration and health status, including obesity. Their work, which contradicts the body of literature cited above, shows an inverse association between incarceration and adult weight gain for men, especially African American men and may point to a protective effect of incarceration for vulnerable populations [14].…”